Healthcare Provider Details

I. General information

NPI: 1740231935
Provider Name (Legal Business Name): LOWCOUNTRY CARDIOLOGY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4969 CENTRE POINTE DR SUITE 100
N CHARLESTON SC
29418-6952
US

IV. Provider business mailing address

4969 CENTRE POINTE DR SUITE 100
N CHARLESTON SC
29418-6952
US

V. Phone/Fax

Practice location:
  • Phone: 843-853-0250
  • Fax: 843-723-4566
Mailing address:
  • Phone: 843-853-0250
  • Fax: 843-723-4566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateSC

VIII. Authorized Official

Name: DR. KENNETH H HANGER JR.
Title or Position: PRESIDENT
Credential: M.D. FAAC
Phone: 843-853-0250